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This information is strictly educational in nature and should not be construed as legal advice. IAHC recommends that you consult with an attorney for a full explanation of any of the above legal tools and how you can properly utilize them.

With aging and health concerns come necessary planning to ensure resources are in place to help with medical and financial decisions and to determine what those decisions might be. Below are some legal tools that may help you ensure that your wishes are carried out should you be unable to make those decisions yourself. With every legal document below, you are designating someone to assist with or make decisions regarding your finances and health decisions. Consult both the individual(s) who you will designate to as well as an attorney to make sure everyone clearly understands what the specific expectations and duration are with each of the following tools:

Power of Attorney (POA)

This is a tool that allows you to designate an individual to act on your behalf. There are two types of POA that are particularly useful for aging adults:

Durable POA: This form grants designated power to another person to make financial decisions on your behalf. For instance, you can grant a sibling or a child access to a bank account to pay bills while you are undergoing and recovering from surgery.

“Springing” or Conditional POA: This document allows another person POA only if something you designate should happen and you cannot make your own decisions, such as mental incapacitation. For instance, this could be a useful tool if you are having surgery or deteriorating health and don’t know if or when you will not be able to make your own decisions.

Durable Health Care Power of Attorney

The durable health care POA allows you to appoint a person to make medical decisions on your behalf in the event you are not able to make them for yourself. This is an essential document to have in your possession before having any type of major surgery, as it lets the hospital know who to ask to make important decisions when you are not able to speak for yourself. In the absence of a durable health care POA, the hospital may not know who to ask. They will have to determine whether a spouse or an adult child. This can be difficult for the hospital to know who to contact and can cause confusion especially when there are multiple decision-makers with different opinion on the use of ventilators, feeding tubes and other life-saving measures.

Advanced Directive (Living Will)

While the durable health care POA informs a treatment facility about who gets to make medical decisions for you if you cannot, it does not give the decision-maker information on your preferences in the case of a life-limiting situation. An advanced directive, or living will, is the document that guides the person making those decisions and medical personnel on what treatment you want. These can be life-sustaining or life- ending decisions, such as deciding to forgo intensive care to keep you alive. Those with an advanced directive should coordinate with the person designated with their durable health care POA to transmit their wishes in advance.

Iowa Physician Order for Scope of Treatment (IPOST)

In addition to a durable health care POA, an IPOST a two-page document that makes it simple for people to select what types of treatment they want and do not want as part of end-of-life care. It is very simple to fill out, with check boxes for the level of care you want to receive, and should only take a few minutes to complete. An IPOST is most useful for those in end-of-life treatment who do not want life sustaining treatment. Without an IPOST form, paramedics and other responders are required to administer life-sustaining treatment, such as CPR.

The document and directions are available here through the Iowa Department of Public Health.

HIPAA Authorization for the Release of Information

This form allows a person to give permission to another person to access their health information. HIPAA (Health Insurance Portability and Accountability Act) prevents doctors and insurance companies prevents from sharing your health information, even with a spouse. This form is useful (and required) if you are allowing a friend or family member access to your health information in order to help you make decisions.

The form is available here. A copy will be needed for every different health care provider or insurance company that you want another person to have access to. However, if you are physically present, you can allow a person access to your health information (i.e. you can let the doctor know it is acceptable for your spouse to stay in the room when discussing lab results).

Will

A will is the most common way for people to state their preferences about how their estates should be handled. Your estate is basically all of a person’s possessions, including real estate, financial assets (including cash, investments, and any life insurance settlement), and physical possessions. A will also establishes your wishes for guardianship of any minor dependents. Having your desires clearly stated helps prevent disagreements regarding the distribution of property.

A well-written will should ease the transition for survivors by transferring property quickly with the knowledge that it follows the wishes of the deceased. A will also establishes a person to administer the distribution of assets. While a will has no direct role in handling your health affairs, the Power of Attorney, durable medical POA, advanced directive, and a will all work together to divide legal responsibilities to loved ones about handling your affairs in the case of your incapacitation or death. Also, they can all be handled by a family attorney well before they need to be used.